University of Michigan School of Dentistry and School of Public Health researchers will present papers on a wide range of topics at the American Association for Dental Research (AADR) meeting in Chicago, March 7-10. Here are highlights of some of their presentations:

CHILDREN’S DENTAL FEARS. Some kids scream at the very sight of a dentist’s chair; others hardly flinch when asked to “open wide.” What makes the difference? U-M School of Dentistry researchers queried parents and dentists for clues. The researchers asked parents and stepparents who accompanied children to a dental clinic to fill out surveys with questions about family income and parents’ health habits and beliefs. The adults also were asked to predict how their children would react to the dentist. Then the dentists, who had not seen the parents’ answers, were asked to rate the children’s behavior.

The more parents dreaded dentists, the more fearful they expected their children to be, says Marita Inglehart, associate professor of dentistry and adjunct associate professor of psychology. But the parent’s fears—and predictions about the child’s fears—were completely unrelated to the child’s actual behavior in the dental chair.

Other findings were not as surprising, says Inglehart. “The lower the family income, the worse the child’s oral health and the more afraid the child will be. That makes sense, because if a child has bad teeth and has a lot of fillings early on, the experience is unpleasant. On the other hand, if you have a parent who takes the child to the dentist every six months for cleaning, and nothing else needs to be done, it’s not surprising that that child has no fear.”

The connection between socioeconomic status, children’s oral health and dental phobias “just alerts us that we should work on policy changes to assure that all kids have dental care,” says Inglehart, who collaborated on the research with dental student Damon O. Watson and Prof. Robert Feigal.

SOFT DRINKS AND CAVITIES. Do sugar-laden soft drinks cause cavities? Conventional wisdom says yes, but dental researchers have had a hard time pinning down the link. With schools installing pop machines and young people’s soft drink consumption on the rise, interest in the question has been increasing. Now, researchers from the U-M School of Public Health and the School of Dentistry have shown that the association between sugared soda consumption and tooth decay may be changing.

Keith Heller, a research investigator in the School of Public Health; Brian Burt, professor of dental public health and adjunct professor of dentistry; and Stephen Eklund, associate professor of dental public health and adjunct professor of dentistry, analyzed data collected as part of the Third National Health and Nutrition Examination Survey, a nationwide study of almost 30,000 people ranging in age from two years old to their seventies. The U-M team found that adults aged 25 and older who drank sugared sodas three or more times a day had 17 percent to 62 percent more decayed, missing and filled teeth than people in the same age group who drank sugary soft drinks less often.

What about the younger folks? “Interestingly, we did not see a difference in persons under age 25,” says Heller. “It’s possible that the effects of consuming sugared soda are cumulative. Maybe just a few years isn’t going to do it, but if habits develop when people are young, you may see an effect over a longer period.” Another possible explanation is that fluoridated drinking water has helped reduce the effects of sugared soft drinks.

Soda consumption is increasing, Heller notes. In 1977, boys aged 12-19 drank an average of 7 ounces of soda per day. By 1987, the figure was 12 ounces, and by 1994 they were guzzling about 18 ounces daily. For girls in the same age group, pop consumption rose from 6 ounces to almost 13 ounces a day between 1977 and 1994.

AFRICAN-AMERICAN ORAL HEALTH. Public health surveys since 1960s have shown that periodontal disease is more common in African Americans than in white Americans, but the reason has been unclear. Researchers have wondered whether racial differences might account for the discrepancy, or whether other factors, such as socioeconomic status, could explain it. In research funded by the National Institute of Dental and Craniofacial Research and the U-M, a School of Dentistry team studied 431 Detroit area non-Hispanic African-American and white adults to sort out the answers.

They found that African Americans were almost twice as likely as non-Hispanic whites to have periodontal disease, but the difference was not due to race per se, says Luisa N. Borrell, who worked on the project as a graduate student. When factors such as age, smoking habits, marital status, self-rated perception of oral health and percent of teeth with tartar were adjusted for, the difference decreased, though it did not disappear entirely. The researchers now want to look more closely at health habits such as frequency of dental check ups to see whether changes in certain habits might close the gap altogether. Borrell did the research with Associate Professor George W. Taylor, senior health science research associate Wenche Borgnakke, Associate Professor Marilyn Woolfolk, clinical department associate Doris Allen, Associate Professor Paul Lang and social science senior research associate Linda Nyquist of the Institute of Gerontology.

DIABETES AND PERIDONTAL DISEASE—NEW INSIGHTS. Researchers have known for some time that people with diabetes are at increased risk for periodontal (gum) disease, but most studies have focused on relatively young patients with Type 1 diabetes (formerly called juvenile diabetes). In new research reported at AADR, George W. Taylor, associate professor of dentistry, and colleagues studied 189 retirement community residents, ranging in age from 50 to 101. In this group, people with Type 2 (adult onset) diabetes were more likely to have periodontal disease-causing bacteria on their teeth and around their gums than were people without diabetes.

“This means that they could be at greater risk both for periodontal problems and perhaps for problems associated with glycemic control,” says Taylor, who collaborated on the work with dentistry student Gregory Solof, Prof. Dennis Lopatin, research associate Janice Stoll and Prof. Emeritus Walter Loesche. Taylor’s previous research has shown that diabetes patients with severe periodontal disease have poorer glycemic (blood sugar) control than those with moderate periodontal disease or none at all.

The researchers now plan a clinical trial to learn whether treating periodontal disease will improve glycemic control in people with diabetes. A pilot study, funded by the National Institutes of Health, will begin in May.

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The U-M School of Dentistry is one of the nation’s leading dental schools engaged in oral health care education, research, patient care and community service. General dental care clinics and specialty clinics providing advanced treatment enable the School to offer dental services and programs to patients throughout Michigan. Classroom and clinic instruction train future dentists, dental specialists and dental hygienists for practice in private offices, hospitals, academia and public agencies. Research seeks to discover and apply new knowledge that can help patients worldwide. More information is available on the Web at http://www.dent.umich.edu.

Related Links:

• Kids’ dental fears
• Soft drinks and cavities
• African American oral health
• Diabetes-periodontal disease link
• School of Dentistry
• Marita Inglehart
• Keith Heller